Not all coping strategies are created equal: a mixed methods study exploring physicians' self reported coping strategies

Abstract

BackgroundPhysicians experience workplace stress and draw on different coping strategies. The primary goal of this paper is to use interview data to explore physicians' self reported coping strategies. In addition, questionnaire data is utilized to explore the degree to which the coping strategies are used and are associated with feelings of emotional exhaustion, a key symptom of burnout.MethodsThis mixed methods study explores factors related to physician wellness within a large health region in Western Canada. This paper focuses on the coping strategies that physicians use in response to work-related stress. The qualitative component explores physicians' self reported coping strategies through open ended interviews of 42 physicians representing diverse medical specialties and settings (91% response rate). The major themes extracted from the qualitative interviews were used to construct 12 survey items that were included in the comprehensive quantitative questionnaire. Questionnaires were sent to all eligible physicians in the health region with 1178 completed surveys (40% response rate.) Questionnaire items were used to measure how often physicians draw on the various coping strategies. Feelings of burnout were also measured in the survey by 5 items from the Emotional Exhaustion subscale of the revised Maslach Burnout Inventory.ResultsMajor themes identified from the interviews include coping strategies used at work (e.g., working through stress, talking with co-workers, taking a time out, using humor) and after work (e.g., exercise, quiet time, spending time with family). Analysis of the questionnaire data showed three often used workplace coping strategies were positively correlated with feeling emotionally exhausted (i.e., keeping stress to oneself (r = .23), concentrating on what to do next (r = .16), and going on as if nothing happened (r = .07)). Some less often used workplace coping strategies (e.g., taking a time out) and all those used after work were negatively correlated with frequency of emotional exhaustion.ConclusionsPhysicians' self reported coping strategies are not all created equal in terms of frequency of use and correlation with feeling emotionally exhausted from one's work. This knowledge may be integrated into practical physician stress reduction interventions.

Practise what you preach: health behaviours and stress among non-consultant hospital doctors

“…Support networks are important to help cope with stress. 16,20 Although moving is a part of the training process, the number of moves should be restricted.…”

Physician Coping Styles and Emotional Exhaustion

“…For example, Carver, Scheier and Weintraub (1989) distinguish between behavioural disengagement (e.g., giving up, admitting defeat) and mental disengagement (e.g., doing other things to take the mind off things, daydreaming about other things). In contrast, the interviews with physicians from the earlier stage of this study suggest that a "time out" may refer to taking break from the emotional intensity of one-on-one patient care by performing an administrative task or a more technical medical procedure (Lemaire and Wallace, 2010). Alternatively, some physicians referred to a time out as stepping outside for a breath of fresh air, taking a coffee break or closing the office door for a bit of quiet time.…”

“…Coping styles reflect four different coping styles based on the results of interview data in an earlier stage of the study (Lemaire and Wallace, 2010) and selected items from established scales from Dallender et al (1999), Rout, Cooper and Rout (1996) and Shanafelt et al (2005). Respondents were asked how often they use each of the following in dealing with the stresses of their work.…”

“…As in their approach, in an earlier stage of this project, we interviewed physicians and asked them to describe how they cope with a difficult day at work while they are at work (Lemaire and Wallace, 2010). Their responses yielded several themes that reflect the following coping responses: active problem solving (e.g., making a plan and working through it), seeking support (e.g., talking it over with colleagues), disengagement (e.g., taking time out) and denial (e.g., keeping it to themselves, going on as if nothing had happened).…”

Survey of practice-related stress among United States and European ophthalmologists

“…Stress relief from physical exercise and religious activity has been described before for patients [17]. However, only exercise has been studied in physicians to our knowledge, and was found helpful in at least one report [19]. Interestingly, religious activity, most often of the Christian faith, scored highest of any activity when used primarily to relieve stress, and was more effective statistically than recreational activities.…”